Individual
JARMIKCO BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
931 WESTWOOD DR STE E, MARRERO, LA 70072-2400
(504) 340-8880
Mailing address
4747 EARHART BLVD STE D, NEW ORLEANS, LA 70125-1747
(504) 482-2600
(504) 482-2644
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447785050
—
LA
Enumeration date
04/21/2017
Last updated
07/18/2019
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